February 1, 2008
by Angela Hussain

Mental health minister Ivan Lewis has questioned the effectiveness of the highly-regarded Henderson therapeutic community which campaigners are fighting to save.

Mr Lewis has doubted the “strength of evidence” for the Henderson Hospital in Surrey, which treats people diagnosed with personality disorder, and is set to close in March.

Former patients of the Henderson Hospital and staff are fighting the closure, and a Facebook group to rally support has been set up.

But in a parliamentary debate last week Mr Lewis said: “I have received no advice suggesting that the [Henderson] model is far superior to other clinical interventions for people with personality disorders....I know that there is a debate about the strength of the evidence for the interventions from the Henderson.

"There is no professional unanimity about whether its care model delivers outcomes so consistently that it would be superior to alternative interventions and models of care.”

Referrals to the unit have dwindled since commissioning was switched from the NHS nationally to local mental health trusts. Referrals decreased from 220 per year to 33 from April 2007 to January 2008.

In December, the South West London and St George's Mental Health NHS trust said it could no longer afford to keep the Henderson open.

Henderson residents run the service in partnership with staff, and residents are not prescribed psychiatric drugs.

Mr Lewis has recommended that the Henderson merge with another therapeutic community, Cassel Hospital in Richmond, south west London.

But Liberal MP Paul Burston urged Mr Lewis to stop the closure. He said: “Unless the minister acts, the NHS is in danger of sleepwalking into the closure of this nationally and internationally-renowned service.”

Kath Lovell, a resident in the Henderson Hospital from 2003 to 2004 and project development manager for the charity, Borderline UK, said: “There are pediatric departments in most hospital trusts, but there will always be need for a specialist hospital like Great Ormond Street, I believe the same to be true with personality disorder and the Henderson.

"I implore for there to be solution that will secure a future for the Henderson that will ostensibly allow more lives to be changed for the better.”

Read also:
Jan 16: 'The Henderson saved my life' - here's why the acclaimed personality disorder unit should stay open, writes Kath Lovell

See also:
Service provision

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Less spin, more facts

Comment from: Karl Adaway, Save The Henderson campaign
Date: February 3, 2008

First, I would like to hear some actual evidence to back up Mr Lewis’s claim about The Henderson. As it is, we have nothing more from Mr Lewis than carefully crafted spin.

Secondly, I would also like to challenge Ivan Lewis to spend a day at The Henderson Hospital. To see first hand how hard people work there, the dedication shown by staff and residents and the levels of motivation needed to make change become reality. Only then could he make an informed decision about what takes place there.

Thirdly, I would also like to challenge St George's Mental Health NHS Trust to produce hard evidence which would justify why it is seeking the closure of The Henderson. And more than the argument over the number of referrals, because the drop has only happened because of the confusion over funding. I would like to see information on true costs, funding, success rates and so on.

With the reported cost of detaining people in police stations being £460 a night, and the reported fact that 50% of acute beds in psychiatric hospitals in the UK are taken up with patients with personality disorders, how do we expect to make ground without pioneering, ground-breaking centres of excellence such as The Henderson?

If The Henderson and other units based on its model are allowed to close, our ignorance WILL cost lives.

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There is the evidence base

Comment from: Fenella Lemonsky, Expert by Experience, North London Hub, MHRN, Imperial College, London
Date: February 4, 2008

I have never used the Henderson but know those who have. I know how it has transformed lives when local services actually made things worse. It has kept families together, kept people out of prison, drugs and alcohol lifestyles and changed things so that people can function better on a daily basis as part of an integrated society rather than be part of social exclusion.

The cost-benefit analysis of specialist personality disorder services as pointed out by health economist Barbara Barrett from the Institute of Psychiatry who has been analysing the "costs" of such speciaist services, is clear. We gain long term.

I appreciate St Georges are in an impossible situation. However super-specialist beds like this should be safeguarded as they are an important part of the treatment options for those not able to be treated in their home town. If these people had a form of cancer that could not be treated locally would they just be told 'tough'?

Personality disorder has a 10% suicide rate . However the good work of the Henderson team which is evidence-based and peer-reviewed has shown it can improve the lives significantly of those who use its services.

As someone fortunate to have specialist PD treatment that saved my life I would ask Mr Lewis to perhaps ask one of his research assistants to do their homework - they clearly did not for him - before he opens his mouth again on such matters.

Eating Disorders Awareness Week is 25 Feb to 5 March 08 see http://www.b-eat.co.uk

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